Short-and Midterm Outcomes of Laparoscopy Assisted Colectomy for Colon and Rectosigmoid Cancer

Background: Laparoscopy-assisted colectomy (LAC) has gained acceptance for the treatment of colon cancer. Objective: To evaluate the use and outcomes of LAC. Patients: Patients who underwent LAC (n = 176) for colon and rectosigmoid cancer (2001-2008). Results: There were 97 men (55.1%) and 79 women(44.9%), whose median age was 67.5 years (range, 33-99 years). The median operating time for patients who underwent LAC was 216 minutes (range, 70-440). The median blood loss was 60 ml (range 10-610 ml). Intra- and postoperative complicacomplications occurred in 3 (1.7%) and 16 patients (9.1%), respectively. The morbidity rate of patients was 0%. The overall survival rates for 3 years were 100.0%, 97.5%, 95.9%, 90.1% and 77.9% for stages 0,Ⅰ,Ⅱ,Ⅲa and Ⅲb, respectively. The relapse-free survival rates for 3 years were 100.0%, 100.0%, 90.1%, 65.7% and 62.3% for stages 0, Ⅰ,Ⅱ,Ⅲa and Ⅲb, respectively. Conclusion: This study confirmed the favorable short-and midterm operative results in patients who underwent LAC

Neoadjuvant chemotherapy with docetaxel, nedaplatin, and fluorouracil for resectable esophageal cancer : A phase II study

Cisplatin plus 5‐fluorouracil is regarded as standard neoadjuvant chemotherapy for esophageal squamous cell carcinoma (ESCC) in Japan, but the prognosis remains poor. We have previously described how definitive chemoradiotherapy with docetaxel, nedaplatin, and 5‐fluorouracil (DNF) led to a very high response rate and promising survival times. We therefore undertook a phase II trial to evaluate the feasibility and efficacy of neoadjuvant DNF. The study included patients with clinical stage Ib‐III ESCC. Chemotherapy consisted of i.v. docetaxel (30 mg/m2) and nedaplatin (50 mg/m2) on days 1 and 8, and a continuous infusion of 5‐fluorouracil (400 mg/m2/day) on days 1‐5 and 8‐12, every 3 weeks. After three courses of chemotherapy, esophagectomy was carried out. The primary end‐point was the completion rate of the protocol treatment. Twenty‐eight patients were enrolled (cStage Ib/II/III, 2/3/23) and all received at least two cycles of chemotherapy. Twenty‐five patients underwent surgery, all of whom achieved an R0 resection, leading to a completion rate of 89.3%. The overall response rate was 87.0%. A pathological complete response was confirmed in eight (32.0%) cases. Grade 3/4 adverse events included leukopenia (32.1%), neutropenia (39.3%), febrile neutropenia (10.7%), thrombocytopenia (10.7%), and diarrhea (14.3%), but were manageable. Treatment‐related deaths and major surgical complications did not occur. Estimated 2‐year progression‐free and overall survival rates were 70.4% and 77.2%, respectively. Thus, DNF therapy was well tolerated and deemed feasible, with a strong tumor response in a neoadjuvant setting for ESCC. This trial is registered with the University Hospital Medical Information Network (UMIN ID: 000014305)

Surgical benefits of liver hanging maneuver for hepatectomy of huge liver tumor

In hepatic surgery, it is very important to control bleeding during liver resection. However, in hepatectomy for a huge liver tumor it is often difficult to reduce bleeding volume and maintain an excellent surgical view. The anterior pproach, which is hepatectomy done using the liver hanging maneuver, has beneficial effects reducing bleeding volume and preventing scattering of cancer cells from huge liver tumors. W e investigated the surgical benefits of the liver anging maneuver during hepatectomy for huge liver tumors in our department.

A case of giant hepatic hemangioma with spontaneous intratumoral bleeding

Cavernous hemangioma is the most common benign tumor of the liver, and most of them remain asymptomatic. However, a giant hemangioma may rupture spontaneously and present severe complications such as shock and anemia, and need emergency operation. We report a case that spontaneous intratumoral bleeding of a giant hemangiona of the liver that occurred in a 55-year-old woman. She presented with severe abdominal pain, anemia, and shock at 3 and a half years after a transcatheter arterial embolization (TAE) treatment. Although the bleeding was under control, a surgical procedure was considered to reduce the risk for rerupture. The general outcome of surgical treatment for giant hemangiomas is satisfactory. In contrast, especially in our case. TAE was unable to reduce the risk of rupture over the long term. Therefore, surgery for giant hemangioma of the liver should be considered as the first treatment to avoid the risk of rupture even in "healthy" case

A Case of Intrahepatic Cholangiocarcinoma with Atypical Multinodular Image Findings

We report the imaging findings of an atypical case of cholangiocarcinoma. The patient was a 59-year-old man, in whom a multicystic liver mass was found on the left lobe of the liver by US. However, the images obtained from contrast CT showed small nodules had gathered and a low density mass in the early phase and peripheral enhancement in the late phase. It seemed to be liver echinococcosis because a group of small nodules appeared on the CT image. An extended left lobectomy of the liver was carried out. The pathological finding was cholangiocarcinoma